Systematic Review and Meta-Analysis of Pestle Needle Therapy in Managing Insomnia, Cervical Spondylosis and Other Systemic Diseases

Objective: To examine the efficacy and safety of pestle needle therapy (PNT) across several prevalent conditions, including insomnia, cervical spondylosis, lumbar disc herniation and other systemic diseases. Methods: We searched eight databases (SinoMed, China National Knowledge Infrastructure, Wanfang Data, VIP Database, Google Scholar, PubMed, Embase and Web of Science) from inception to 31 December 2023, using both subject terms and free-text terms related to ‘pestle needle’ and ‘randomised controlled trial’. Eligible randomised controlled trials (RCTs) that investigated PNT alone or in combination with other therapies were included. Primary outcomes included the overall response rate (ORR) and incidence of adverse events. Results: A total of 29 RCTs involving 2,614 patients were included. Meta-analysis results showed that, compared with controls, PNT significantly improved ORR in insomnia (odds ratio [OR] = 4.07, 95% confidence interval [CI]: 2.33, 7.09), cervical spondylosis (OR = 4.38, 95% CI: 2.41, 7.97), lumbago and leg pain (OR = 3.32, 95% CI: 1.86, 5.91) and lumbar disc herniation (OR = 1.92, 95% CI: 1.12, 3.29). Regarding cervical spondylosis, the intervention of the observation group was significantly better than that of the control group (Z = 4.84, P < 0.001). In terms of low back pain and leg pain, the intervention of the observation group was significantly better than that of the control group (Z = 4.07, P < 0.001). The intervention of the observation group was significantly better than in the control group in improving the total effective rate of the treatment of lumbar disc herniation (Z = 2.37, P = 0.02). Conclusion: Pestle needle therapy is a safe and effective treatment modality that can complement or substitute conventional interventions. This systematic review and meta-analysis contributes to the evidence base for acupuncture-related therapies, highlighting the potential of PNT to address both musculoskeletal and neurological conditions, thus offering new clinical options and underscoring the need for large-scale, high-quality RCTs to refine treatment protocols.